Active NPI
Yolanda Heredia Matos, DMD
- General Practice Dentistry
- San Lorenzo, PR
National Provider Identifier
1568420461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2504
- Practice address
- Plaza Buxo Carr 181
Edif 2 Local 3
San Lorenzo, PR 00754 - Phone
- (787) 715-1490
- Fax
- (787) 715-0322
- NPI assigned
- May 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2504 | PR | Primary |
Addresses
Primary practice location
Plaza Buxo Carr 181
Edif 2 Local 3
San Lorenzo, PR 00754
Mailing address
RR 36 Box 6164
San Juan, PR 00926
Phone (787) 715-1490
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2504 | PR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568420461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 36 BOX 6164",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00926",
"telephone_number": "787-715-1490",
"fax_number": "787-715-0322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PLAZA BUXO CARR 181",
"address_2": "EDIF 2 LOCAL 3",
"city": "SAN LORENZO",
"state": "PR",
"postal_code": "00754",
"telephone_number": "787-715-1490",
"fax_number": "787-715-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEREDIA MATOS",
"first_name": "YOLANDA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PR",
"license": "2504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Lorenzo, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.